Presentation
Intermittent vaginal wetting, especially on standing; status post hysterectomy. Cystoscopy was normal.
Patient Data
No extravasation of contrast material from the bladder.
CT after maneuver to increase intra-abdo pressure
Contrast material from bladder enters the vaginal canal after the patient was asked to stand upright for two minutes in an attempt to increase the intra-abdominal pressure.
No distinct fistula tract can be seen.
Contrast material from bladder into the vaginal canal (yellow arrow) after the patient was asked to stand upright for two minutes in an attempt to increase the intra-abdominal pressure.
Black arrow shows irregularity and protrusion of bladder wall with no distinct fistula tract.
Case Discussion
Vesicovaginal fistula is the most commonly acquired fistula of the urinary tract and is rarely seen as a postoperative complication of hysterectomy.
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